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  • Cervical spinal cord  (1)
  • Clinico-radiological correlation  (1)
  • Demyelinisierung  (1)
  • 1
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Multiple Sklerose ; Magnetresonanztomographie ; Protonenspektroskopie ; Magnetisation-Transfer ; Demyelinisierung ; Key words Magnetic resonance imaging ; Multiple sclerosis ; Proton spectroscopy ; Magnetisation transfer ; Demyelination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary We investigated a patient with secondary progressive Multiple Sclerosis during an acute relapse and after 6 months using several Magnetic Resonance methods. Conventional Magnetic Resonance images demonstrated at the time of relapse a large gadolinium enhancing lesion. Using proton spectroscopy and Magnetisation Transfer images heterogeneous changes suggestive of oedematous swelling peripherally, and active myelin destruction centrally were demonstrated in the acute phase. After clinical recovery there was marked resolution of acute inflammatory Magnetic Resonance abnormalities and recovery of MR tissue parameters. In comparison with conventional Magnetic Resonance Imaging Magnetisation Transfer Imaging and Proton Spectroscopy provide improved characterisation of pathological changes in MS.
    Notes: Zusammenfassung Wir untersuchten eine Patientin mit sekundär progressiver multipler Sklerose während eines akuten Schubes und im Verlauf nach 6 Monaten mit verschiedenen Magnetresonanztechniken. In der konventionellen Bildgebung fand sich zeitgleich zur klinischen Verschlechterung eine ausgedehnte kontrastmittelanreichernde Läsion. Mittels der Protonenspektroskopie und Magnetisation-Transfer-Bildern konnten heterogene pathologische Veränderungen mit wahrscheinlich ödematösen Gewebeveränderungen in der Peripherie und Demyelinisierung im Zentrum der Läsion in der akuten Phase dargestellt werden. Mit dem Abklingen der akuten Symptomatik zeigte sich eine Rückbildung der akut entzündlichen Aktivität und eine Erholung der MR-Gewebeparameter. Im Vergleich zur konventionellen Magnetresonanztomographie bieten Magnetisation Transfer Bildgebung und Protonen Spektroskopie spezifischere Informationen bei der Darstellung pathologischer Gewebeveränderungen der multiplen Sklerose.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1920
    Keywords: Key words Magnetisation transfer ratio ; Cervical spinal cord ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI readily detects the lesions of multiple sclerosis (MS) in the brain and spinal cord. Conventional MRI sequences do not, however, permit distinction between the various pathological characteristics (oedema, demyelination, axonal loss and gliosis) of lesions in MS. Magnetisation transfer (MT) imaging may be more specific in distinguishing the pathologies responsible for disability in MS, namely demyelination and axonal loss, and therefore may have a potential role in monitoring treatment. We have applied MT imaging to the cervical spinal cord to see if it is feasible to measure MT ratios (MTR) in this region where pathological changes may result in considerable disability. We studied 12 patients with MS and 12 age- and sex-matched normal controls using a sagittal T2-weighted fast spin-echo sequence with and without an MT pulse. The median value for cervical cord mean MTR measurement in normal controls was 19.30 % units (interquartile range 19.05–19.55), whereas values were significantly lower in MS patients (median = 17.95 % units, interquartile range 17.25–19.00, P = 0.0004). There was a low intrarater variability for repeated mean MTR measurements. We conclude that it is possible to measure MTR in the cervical spinal cord, that a significant reduction occurs in patients with MS, and that there may be a role for this measure in future MS treatment trials.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1459
    Keywords: Key words Multi-parametric ; Multiple sclerosis ; Magnetic ; resonance imaging ; Lesion volume ; Clinico-radiological correlation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Magnetic resonance imaging (MRI) is frequently used to monitor new treatments in multiple sclerosis (MS), but its role is limited by the uncertain relationship between MRI parameters and clinical disability. A brain MRI study using nine MRI parameters was undertaken in 15 MS patients with a wide spectrum of disability to evaluate the relationship between each parameter and disability. A strong correlation was found between disability (measured using Kurtzke’s EDSS) and total lesion load on both proton density (PD; r = 0.79) and T1 (r = 0.71) weighted sequences. There was also a strong correlation of disability with average lesion magnetisation transfer ratio (MTR; r = –0.74) and calculated T1 (r = 0.71) but not with calculated T2 or the average signal intensity of lesions on the conventional T1-weighted, PD-weighted and heavily T2-weighted images. Thus, four parameters which measured either the extent of lesions (PD lesion load) or their pathological severity (MTR, calculated T1, hypointense T1-lesion load) were correlated significantly with disability. While this suggests that such parameters will be useful in treatment trial monitoring, further multi-parameter MRI studies, of larger cohorts and using a wider range of techniques, are indicated.
    Type of Medium: Electronic Resource
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